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剖析利比里亚自我评估健康状况中的性别不平等现象。

Decomposing gender inequalities in self-assessed health status in Liberia.

作者信息

Murendo Conrad, Murenje Gamuchirai

机构信息

a Monitoring, Evaluation, Impact and Learning , International Crops Research Institute for the Semi-Arid Tropics , Bulawayo , Zimbabwe.

出版信息

Glob Health Action. 2018;11(sup3):1603515. doi: 10.1080/16549716.2019.1603515.

Abstract

: Understanding the magnitude of inequalities and drivers for reducing gender-related health inequalities is crucial in developing countries. This is particularly the case for Liberia with its very high level of gender-related inequalities in health and health outcomes. : This paper assesses the magnitude of gender health inequalities and the relative contribution of different factors to health inequality in Liberia. : Data came from the Liberian Household Income Expenditure Survey 2014. A two stage sampling methodology was used and 4,104 households were randomly selected and interviewed. The main variable of interest is dichotomised, good versus poor self-assessed health. Gender-related health inequality is assessed using the Oaxaca-Blinder decomposition for non-linear models. The decomposition reveals the magnitude of inequality and contributions of different factors. : We found large gender disparities (0.054, p < 0.01) characterised by women disadvantages in health status. In addition, the gender health disparities are mostly pronounced in rural areas. About 54% of the gender inequalities in health status were explained by the differences in endowments. Equalizing access to information, wealth and utilization of mosquito nets would reduce the gender gaps by 44, 5 and 4%, respectively. : Addressing gender health inequalities inter alia requires access to health information (i.e. electronic and print media), gender responsive interventions that improve wealth in key sectors (i.e. education, employment, social protection, housing, and other appropriate infrastructure). In addition, the government, private sector and civil society should ensure that the health sector provides access to quality mosquito nets and improved health services including preventive care in order to reduce disease burden.

摘要

在发展中国家,了解不平等的程度以及减少与性别相关的健康不平等的驱动因素至关重要。利比里亚的情况尤其如此,该国在健康及健康结果方面存在非常严重的与性别相关的不平等。本文评估了利比里亚性别健康不平等的程度以及不同因素对健康不平等的相对贡献。数据来自2014年利比里亚家庭收入支出调查。采用两阶段抽样方法,随机选取4104户家庭进行访谈。主要关注变量被二分,即自我评估健康状况良好与不佳。使用针对非线性模型的奥瓦卡-布林德分解法评估与性别相关的健康不平等。该分解揭示了不平等的程度以及不同因素的贡献。我们发现存在巨大的性别差异(0.054,p<0.01),其特征是女性在健康状况方面处于劣势。此外,性别健康差异在农村地区最为明显。健康状况方面约54%的性别不平等可由禀赋差异来解释。使获取信息、财富和使用蚊帐的机会均等,将分别减少44%、5%和4%的性别差距。解决性别健康不平等问题尤其需要获取健康信息(即电子和印刷媒体),需要采取对性别问题有敏感认识的干预措施,以提高关键部门(即教育、就业、社会保护、住房和其他适当基础设施)的财富水平。此外,政府、私营部门和民间社会应确保卫生部门提供获取优质蚊帐的机会,并改善包括预防保健在内的卫生服务,以减轻疾病负担。

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